An arterial switch would be the treatment of choice for transposition of the great arteries, since it results in the most anatomically normal heart with the fewest long term complications.
In this procedure the great vessels are transected and reanastomosed to the appropriate ventricles. In addition to this the coronary arteries must be reanastomosed from what was the aortic outflow tract to the new aortic outflow tract.
This operation must be accomplished in the first two weeks of life before the left ventricle regresses with the falling pulmonary resistance. This operation used to carry 10-30% mortality; this has improved, and if successful is corrective in the long term.
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